Everyday Considerations

This is difficult to say; it depends on the reason for ketosis. As long as ketone levels are greater than 0.5 mmol, you’re in ketosis. Many people think that higher ketone levels are better, but this has yet to be established. Some individuals who have been keto-adapted for an extended period may become particularly efficient at using ketones and therefore don’t have a lot of them circulating in the blood. For some health concerns, such as epilepsy and other neurological conditions, higher ketone levels may be beneficial—exogenous ketones or high-dose MCT may be especially helpful in order to accomplish those levels.

You can test your ketone levels using urine strips, blood ketone meters, and breath ketone meters. Blood meters, which test for BHB, are considered the gold standard. Breath analysis has been shown to be effective at measuring acetone, while urine analysis measures acetoacetate. Urine strips can provide good feedback at the beginning of the diet, but once you’re keto-adapted and using ketones more efficiently, fewer ketones are expelled in the urine, so they are not a reliable indicator of degree of ketosis.

Ketosis is generally recognized to occur when ketone levels rise to 0.5 mmol. Two days of carbohydrate restriction can be enough to reach this level. However, achieving this level of ketosis does not mean that you are keto-adapted—that your body is primarily using fat as fuel. Becoming fully keto-adapted may take longer; exactly how long varies from person to person.

No. MCTs can be converted into ketones once they’re broken down in the liver . However, some research suggests that it takes extremely high amounts of MCT (more than 20 grams) to get the same effects that just a couple grams of exogenous ketones could achieve.

Exogenous ketones likely do not cause fat loss directly. Keep in mind that they are an energy source and do have calories.  However, having elevated ketone levels has been shown to reduce hunger, increase the production of new mitochondria, and decrease the ratio of weight gained to amount of food consumed , which could allow for greater fat burning and incidentally reduce body weight.

Check out our entire Ketone Resource Section here:

Exogenous ketones are supplemental ketones that are found in either powdered or liquid form. The powdered versions are bound to minerals such as calcium, sodium, or magnesium, while the liquid forms primarily consist of  ketone esters. Exogenous (outside) ketones are ketones that are ingested and, upon consumption, behave similarly to the endogenous ketones that the body produces due to carbohydrate restriction.

Check out our entire KetoClass on exogenous ketones here.

Saturated fat should not be demonized, especially on a ketogenic diet. However, we have found that our bodies adapt best when saturated fat represents about 50 percent of our total fat intake and the rest comes from monounsaturated fats like oils and avocados. This could, in part, explain why so many studies have different findings in regards to cholesterol and triglyceride levels following a ketogenic diet . If you are concerned about these factors, ensuring that you consume a balance of saturated and monounsaturated fats may be a good approach for you.

When you are keto-adapted, you become much more efficient at utilizing fat as fuel, and some studies show that slightly overfeeding on fat alone may not cause significant weight gain. However, keep in mind that fat is calorically dense, with 9 calories per gram. Eating excessive amounts of fat can increase calories to an extent that may prevent certain benefits from occurring, such as fat loss. Supplying your body with too much dietary fat may keep it from breaking down your own fat stores for energy. As with everything, keep the fat content of the diet in context, and don’t binge on fat bombs.

We do not intend to demonize carbohydrates as the sole culprit for the obesity epidemic we are facing. Instead, we hope to change the paradigm of a “healthy” diet model to help people look at carbohydrates as a useful tool rather than a dietary necessity. Although, it is true that chronic high carbohydrate consumption can lead to chronic high blood glucose and insulin levels, resulting in metabolic changes such as insulin resistance that increase the likelihood of becoming obese, it is possible for many people to consume carbohydrates and maintain a healthy profile.

While some amino acids, such as leucine and lysine, can be converted to ketones, others can be converted into glucose and may therefore raise blood glucose and insulin levels if consumed in excessive amounts. For this reason, we suggest consuming no more than 20 to 35 percent of your calories from protein. Keep in mind that the optimal level varies from individual to individual—for instance, someone using a ketogenic diet to help with epilepsy may need less protein than someone using it to try to gain high amounts of muscle mass.

It’s common to reduce fiber intake when switching to a ketogenic diet, simply because fiber is most abundant in foods that are high in carbohydrates, particularly vegetables and grains. Fiber is an important nutrient that’s essential for good health, and although it is technically a carbohydrate, it does not increase blood glucose or insulin levels. So we highly recommend making an effort to get enough fiber unless you are on a carnivore or low fiber diet, in which the approach is slightly different.

Potassium, magnesium, and calcium also can become depleted on a ketogenic diet.

Sodium levels do drop on a ketogenic diet, so it’s a good idea to consume more sodium.  Real Salt can be a great, beneficial source because it contains many minerals, including sodium, calcium, potassium, iodine, and magnesium, with a sodium content similar to table salt but with larger crystals for more flavor.

A target macronutrient ratio can be a good place to start, but keep in mind that the macros that work best for you and your lifestyle may differ from what works for someone else. The key is to keep carbohydrate intake low, protein moderate, and fat moderate to high. Have fun with it and tinker with your diet until you figure out what is optimal for you. Once you have individualized the diet to work best for you, and after you have been on it for a while, you will learn what you should and shouldn’t eat to maintain your optimal ratio, and therefore you may not need to count macronutrient content as strictly.

When you first start following a ketogenic diet, we recommend tracking macronutrients and calories just to get the hang of it and to make sure that you’re getting the right amount of each. However, soon after adapting, you should simply be able to eat until you are full while monitoring your carbohydrate intake. Don’t let those sneaky carbohydrates creep up too high. In fact, people who are keto-adapted often reduce their calories unintentionally simply because they feel full faster. If possible, eat to satiety once you get the hang of it; your keto-adapted appetite should ensure that you consume enough calories without overeating.  Those using the diet for therapeutic application should incorporate some level of calorie control/restriction in order to receive the best results from the diet.

For a reference on where to start in terms of calorie needs, check out our calculator here.

If using a well-formulated ketogenic diet, then no; not only is the high amount of fat on a ketogenic diet satiating, but ketones also seem to reduce hunger signals. Studies have allowed subjects on a ketogenic diet to eat as much as they want, yet they still tend to eat fewer calories, report less hunger, and lose more weight than those on a non-ketogenic diet . It is possible that this is because fat is more calorically dense; however, studies have also demonstrated that being in a state of ketosis can reduce hunger signals.

Although both Atkins and a ketogenic diet feature similar levels of carbohydrate restriction, the two differ in protein and fat intake. The Atkins diet typically allows individuals unrestricted protein intake. However, on a ketogenic diet, protein intake tends to be around 10 to 30 percent to allow for the production of ketones.

There’s no strict definition of “low carb.” Some studies suggest that a low-carb diet is any diet with less than 30 percent of calories coming from carbohydrates . A ketogenic diet generally restricts carbohydrates further, to as low as 5 percent of total calories. So while a ketogenic diet is certainly low-carb, not all low-carb diets are ketogenic. The greater restriction of carbohydrates on a ketogenic diet results in the production of ketones.

Ketones are produced during the breakdown of fat by the liver. Fat is primarily broken down for fuel when carbohydrate consumption (and insulin) is low.

Below are actions to consider taking to continue losing fat:

• Track macros
• Check calorie consumption
• Weigh food
• Alter meal frequency
• Implement a fasting period
• Ensure adequate sleep
• Include exercise
• Restart the Keto Club Method

Ketogenic.com suggests tracking total carbohydrates (fiber + non-fiber carbohydrates) in the initial stages of “keto-adaptation;” however, once adapted, one may be able to track “net” carbs (non-fiber carbohydrates – fiber).

For more information on the difference between total and net carbohydrates check out this article here.

Start by telling them about the ketogenic diet and offering them educational materials such as this book or pointing them to online resources, such as Ketogenic.com. Perhaps even gift them a membership to Ketogenic.com+ to help get them started.

While eating more carbs every weekend may not be ideal , slip-ups do happen, and while they should be rare, they do not require you to panic. If you get kicked out of ketosis, you may feel groggy or have a hard time focusing, but just get back on track and you’ll feel normal again soon. The longer you’ve been keto-adapted, the quicker you’ll get back into ketosis after a cheat day.

As with any diet, it is possible to hit a plateau on the ketogenic diet. If this happens to you, it is time to reassess your diet. Ask yourself the following questions:

• Are my carbs low enough?
• Have I tried increasing or decreasing my protein intake?
• What are my total calories?
• Have I tried cutting out dairy?
• Am I consuming too many artificial sweeteners?
• Have I tried tracking my macros and measuring my food?

Keep in mind that the number on the scale doesn’t always tell you what’s really going on. If you lose 2 pounds of fat and gain 2 pounds of muscle, you may not have lost any “weight,” but you are doing a great job because you are losing fat and gaining muscle, which is exactly what you want.

Absolutely. In fact, we find that eating out on a ketogenic diet is much easier than eating out on a low-fat diet. You can never go wrong with a nice Cobb salad or a fatty cut of meat with a side of vegetables cooked in melted butter. Be careful of hidden carbs, such as those in sauces and dressings. Don’t be afraid to ask your server how something is prepared prior to ordering.

If you’re traveling and want to take along a snack, pack some nuts, pork rinds (or pork skins), and/or Parmesan crisps.

Though it’s possible to eat keto forever, studies have shown that once you are adapted, you could transition to eating low carb for a few days/weeks before going back to strict keto. This does not mean eating keto for a couple of weeks and then eating a high carb, standard American diet for a couple weeks, etc. as that would not be beneficial.  It is important to understand that this flexibility should come after you are adapted and not just in the beginning.

If you “slip up” on a ketogenic diet, it is not the end-of-the-world nor does it mean you should continue to fall further off of the wagon. Unfortunately, having frequent “slip-ups” or “cheat days” may prevent you from becoming “keto-adapted” and seeing the results you are looking for.  However, an occasional “slip-up” for someone who is already “keto-adapted” will likely not be detrimental. Get back on track and get back in your routine. Find support groups and alternative recipes to avoid these pitfalls and setbacks. If you are using the dieet for therapeutic purposes, it is important to avoid these setbacks as much as you can and get back into ketosis as soon as possible.

One of the many benefits of being in a ketogenic state is muscle preservation. Research has demonstrated that ketones prevent muscle catabolism/breakdown. Furthermore, recent research also suggests that ketones may actually help with muscle anabolism/building muscle anabolism as well. For these reasons alone, eating a well formulated ketogenic diet with adequate amounts of protein would still allow you to maintain or even increase muscle mass.

MCTs are fatty acids that are structurally shorter than long-chain triglycerides (LCTs).  While LCT’s require processing from the gallbladder, MCTs are rapidly digested and directly used for energy, with a lower propensity for fat storage. These fats are a staple on the ketogenic diet and can be easily converted to ketones!